Bariatric Embolization in the Treatment of Patients with a Body Mass Index Between 30 and 39.9 kg/m2 (Obesity Class I and II) and Metabolic Syndrome, a Pilot Study.

INTRODUCTION: To evaluate the efficacy and clinical safety of bariatric arterial embolization (BAE) in adults with body mass index (BMI) between 30 and 39.9 kg/m2 and metabolic syndrome (MS). MATERIALS AND METHODS: Between March and August 2018, ten female participants between 21 and 48-years-old, median BMI of 36.37 ± 2.58 kg/m2 and MS were enrolled in this prospective trial. We embolized the fundal branches from the left gastric and other artery sources, which resulted in embolization of at least two arteries in 9 out 10 participants. Six months after bariatric embolization, efficacy was assessed by changes in total body weight (TBW), ghrelin and Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) levels and by changes in quality of life (QOL) and in binge eating scale (BES) scores. Safety was assessed by the identification of any related complications, including gastric ulcers, screened by gastrointestinal endoscopy, performed before and one week and one month after BAE. RESULTS: Six months after embolization, TBW decreased by 6.8% (6.22 kg ± 3.6;p = .01), serum ghrelin dropped from 25.39 pg/ml ± 10.63 to 17.1 ± 8.07 (p = 0.01), and HOMA-IR decreased from 7.29 ± 5.66 to 3.73 ± 1.99 (p = 0.01). The QOL scores improved from 59.64 ± 5.59 to 69.02 ± 11.97 (p < 0.05) and in the BES from 21.50 ± 8.89 to 9.60 ± 4.40 (p = 0.01). Endoscopy revealed symptomatic gastric ulcers in two participants, which had healed without sequelae. In one participant, ultrasound revealed an asymptomatic focal arterial thrombus at the left distal radial artery puncture site. CONCLUSION: BAE is effective in reducing weight, insulin resistance and ghrelin levels and improving BES and QOL scores in patients with class I and II obesity and MS, with no major complications.

Prevalência de sobrepeso e obesidade em escolares da rede pública do município de Jundiaí, São Paulo / Prevalence of overweight and obesity among children of public schools in the city of Jundiaí, São Paulo, Brazil

OBJETIVO: Determinar a prevalência de obesidade de acordo com o nível socioeconômico e o sexo, em escolares do ensino fundamental, segundo dois critérios diagnósticos. MÉTODOS: Realizou-se um estudo transversal nas escolas públicas de ensino fundamental de Jundiaí, São Paulo, com 662 alunos de quinta a oitava séries, com idades entre dez e 18 anos, em 2005. A amostra foi selecionada por meio de procedimento sistemático, de acordo com a série e o sexo. Calculou-se o índice de massa corpórea (IMC). Os pontos de corte para classificação do estado nutricional foram escolhidos de acordo com dois critérios antropométricos: valores de IMC em percentil e valor numérico de IMC como ponto de corte. RESULTADOS: A prevalência de sobrepeso foi 17 por cento quando se utilizou o critério de percentil e 13 por cento ao usar o corte por valor numérico. A prevalência de obesidade foi 8 e 9 por cento, respectivamente. Houve diferença quanto ao sexo, quando se utilizou a classificação por percentil, com maior percentual de magreza encontrado no sexo masculino. O sobrepeso e a obesidade foram mais observados em adolescentes de melhor condição socioeconômica. CONCLUSÕES: A prevalência de sobrepeso e obesidade foi elevada, sendo maior nas classes mais favorecidas. A medida do IMC por percentil detectou maior número de adolescentes com sobrepeso e obesidade, comparada à classificação por valor numérico.

OBJECTIVE: To determine the prevalence of obesity related to gender and socioeconomic level in students of public schools, according to two different nutritional criteria. METHODS: A cross-sectional study was performed in public schools of the city of Jundiaí, São Paulo, Brazil, and included 662 students with 10-18 years old that attended 5th-8th grades, in 2005. The sample was selected using systematic procedure, according to the student's grade and gender. The body mass index (BMI) was calculated and cutoff points were selected for classification of nutritional state according to two anthropometrics criteria: values of BMI as percentiles and as sharp cutoff point. RESULTS: The prevalence of overweight was 17 percent using the percentile criteria and 13 percent with the numerical cutoff. The frequency of obesity was 8 and 9 percent, respectively for both criteria. Difference between genders was found using the percentile criteria, with higher percentage of leanness in males. Overweight and obesity were more frequent among adolescents of better socioeconomic status. CONCLUSIONS: The prevalence of overweight and obesity were higher in students of better economic classes. The BMI percentiles detected a higher number of adolescents with overweight and obesity compared to the numerical cutoff.